Breast implants remain incredibly popular, but have been associated with certain cancers. Breast implant procedures are the top cosmetic surgery performed in the US, with 290,467 procedures in 2016, according to the American Society of Plastic Surgeons. Recently the FDA has updated its understanding of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) to reflect the agency’s agreement with the World Health Organization designation of BIA-ALCL as a rare T-cell lymphoma that can develop following breast implants. At this time, most data suggest that BIA-ALCL occurs more frequently following implantation of breast implants with textured surfaces rather than those with smooth surfaces.
BIA-ALCL is a rare condition; when it occurs, it has been identified most frequently in patients undergoing implant revision operations for late onset, persistent seroma. As of Feb. 1, the agency had received a total of 359 reports of the cancer associated with the implants. The deaths were not caused by breast cancer, the agency said, but by a rare malignancy in the immune system, anaplastic large-cell lymphoma. In cases linked to implants, this rare form of cancer grows in the breast, usually in the capsule of scar tissue that forms around an implant. It is usually treatable and not often fatal. The contents of the implants appeared much less important: Of 312 cases where the contents were known, 186 were filled with silicone gel, and 126 with saline. Cases generally come to light when symptoms develop, like lumps, pain, fluid buildup and swelling.
In 2011, the FDA identified a possible association between breast implants and the development of anaplastic large cell lymphoma (ALCL), a rare type of non-Hodgkin’s lymphoma. It asked doctors whether they noticed changes in their patients and for women to check for symptoms such as fluid buildup, hardening or a mass around their implants. Symptoms of the cancer also include swelling and redness around the breast implants. Since that report six years ago, the scientific community has learned more about the link between breast implants and ALCL. Most cases of ALCL have been described as a slow-growing and treatable when it’s detected early
Why there is a difference in risk related to the surfaces is not known, but the body’s reaction to textured implants is different from its reaction to smooth ones, according to Dr. Alex K. Wong, a plastic surgeon and researcher at the University of Southern California’s Keck School of Medicine. Tissue grows into microscopic grooves in the textured implants. “When we take these out, you can hear a peeling sound,” Dr. Wong said. “Whereas with a smooth implant, it’s like Jell-O. You can spin it around. It moves really easily.”
Studies in rats in his laboratory show different levels of genetic activity in the animals’ tissues in response to smooth versus textured implants. “We’re still trying to find out why the surface matters,” he said, adding that in some cases the cancer seems also to be associated with a certain bacterial infection. Surgeons use textured implants if they want the implant to stick in place and not move, which is important for newer, anatomically shaped implants that would look bad if they were to shift or turn upside down.
Before getting breast implants, make sure to talk to your health care provider about the benefits and risks of textured-surface vs. smooth-surfaced implants. People who have breast implants should monitor their implants for any changes and get routine screenings such as mammograms or MRIs as recommended by their doctors, the FDA recommends. If you need a mammogram that uses less compression and is less traumatic to your implant call PINK Breast Center for an appointment today in Flemington at 908-284-2300 or Paterson at (973) 977-6662